A case of acute myeloid leukemia diagnosed in a patient with a mandibular fracture: emphasis on perioperative infection control

DOI Web Site 26 References
  • NAKANISHI Koji
    Department of Dentistry and Oral Surgery Kasukabe Municipal General Hospital
  • GOTO Toshiyuki
    Department of Dentistry and Oral Surgery Kasukabe Municipal General Hospital
  • TAKEDA Akio
    Department of Dentistry and Oral Surgery Kasukabe Municipal General Hospital
  • ASAKA Yousuke
    First Department of Oral and Maxillofacial Surgery Nihon University School of Dentistry
  • SATO Takako
    First Department of Oral and Maxillofacial Surgery Nihon University School of Dentistry
  • OHKI Hidero
    First Department of Oral and Maxillofacial Surgery Nihon University School of Dentistry

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Other Title
  • 下顎骨骨折を契機に発見された急性骨髄性白血病の1例
  • 下顎骨骨折を契機に発見された急性骨髄性白血病の1例--周術期感染管理について
  • カガクコツ コッセツ オ ケイキ ニ ハッケン サレタ キュウセイ コツズイセイ ハッケツビョウ ノ 1レイ シュウジュツキ カンセン カンリ ニ ツイテ
  • 窶博・p期感染管理について窶髏€

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Abstract

We report the rare case of a mandibular fracture in a patient with acute myeloid leukemia(AML). A 69-year-old man was referred to us because of a mandibular fracture. On admission, the white cell count was 14100/μl with 69.5 % blastoid cells, the hemoglobin level was 6.9 g/dl, and the platelet count was 23000/μl. Bone marrow aspiration revealed hypercellular marrow containing many peroxidase-positive blastoid cells(85.4 %). A mandibular fracture with AML was diagnosed, and we initially planned an operation for the mandibular fracture. However, because infection is known to be the most common cause of death in patients with leukemia, antibiotics were administered in accordance with the guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Subsequently, fixation of the mandible and drainage of the intermandibular space were performed, with no evidence of severe infection in the perioperative period. On postoperative day 13, the patient received induction therapy with cytarabine and idarubicin. Although the leukemia responded well to chemotherapy, the patient died of an intracerebral hemorrhage after consolidation therapy.

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